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Understanding service virtualisation: where to start

Dr Arun Alfred, Consultant Haematologist, The Rotherham NHS Foundation Trust discussed Understanding service virtualisation and where to start at today’s conference. Dr Arun Alfred discussed:

  • understanding service virtualization: the theory
  • tools and pathways
  • where to start? Lessons from our virtual clinics
  • looking ahead to a ‘virtual’ care pathway

Dr Arvind Madan full presentation is available for download at the end of this page.

In his presentation Dr Arun Alfred discussed the changing clinical needs of patients and increasing demand for clinical services have presented to the medical fraternity the challenge of adapting our current clinical service provision to adequately meet the needs of our patients.

There is increased blurring of lines between primary and secondary care with an increased focus on care and consultation to be delivered to the patient closer to home. In collaboration with the local GP Commissioning Consortium, Rotherham Hospital has established dedicated virtual clinics for evaluation of Clinical Haematology patients. Suitable for any patient for whom GPs may require initial discussion and advice, but not necessarily a direct referral to secondary care, the virtual clinics provide a direct contact to named Consultants by email or telephone at specified times each week.

The development process included setting up of a steering group of stakeholders from Primary and Secondary care teams to design a new patient pathway and to develop consensus across the local medical community for the delivery of the service.  As part of this service, for patients discussed via the V clinic who need to be seen in OPD, an appointment was made through the V clinic by liaising directly with the contact centre (GP informed at the same time). In the evaluation period around 100 patients received ‘virtual consultation’ and 90% were discharged or were to be followed up in Primary Care.  In our experience the Virtual Clinic provides a streamlined pathway for Haematology referrals enabling direct and timely two- way communication between Primary Care and Secondary Care Physicians helping reduce inappropriate hospital outpatient visits.

Dr Arun Alfred stated: 

“Where to start? Get the local context, Identify all stakeholders Patient-Provider-Commissioner and Focus on an initial area-pilot”

“You have to really understand what what your local economy needs”

“Learn lessons from a pilot area first”

“To gain your stakeholders prescriptive you can use Focus groups, One-on-one interviews, patient consensus via email and workshops.”


  • E-mails may not always be picked up within the correct time frame- locum GPs, annual leave, late
  • Impact on current clinical provision
  • Robust system to track activity.
  • Complete coverage of all GP practices: Finance and contracting arrangements"

“If you are thinking of virtualisation - Clarify Goals, Prioritise Objectives, Establish Policies and Procedures, Operational Issues, Integrating IT systems and Personnel”

Download: Dr Arun Alfred Presentation

20 April 2015


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